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Flashcards in Fluids Deck (66)
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1
Q

Which type of fluid is given with blood

A

normal saline (9%)

2
Q

hyper/iso/hypo tonic: d5 in water

A

iso -> hypo tonic

3
Q

hyper/iso/hypotonic: d5 1/2 normal saline

A

hypertonic

4
Q

hyper/iso/hypotonic: normal saline

A

isotonic

5
Q

hyper/iso/hypotonic: d5 in normal saline

A

hypertonic

6
Q

hyper/iso/hypotonic: lactated ringer’s

A

isotonic

7
Q

Use for Packed Red Blood Cells

A

blood loss

8
Q

Use for fresh frozen plasma

A

trauma, burns, shock, bleeding/clotting disorders

9
Q

Use for platelets

A

thrombocytopenia

10
Q

Use for cryoprecipitate

A

used for clients with hereditary disorders that lead to inadequate clotting

11
Q

What is cryoprecipitate derived from?

A

plasma

12
Q

type and crossmatch

A

determining blood type and Rh factor

13
Q

universal donor blood type

A

o neg

14
Q

universal recipient blood type

A

AB positive

15
Q

t/f: a consent must be obtained before administration of any blood type

A

true

16
Q

Signs of a transfusion reaction

A

fever/chills, altered BP, dyspnea, allergic reaction

17
Q

loss of body water but electrolytes remain consistent

A

dehydration

18
Q

loss of both fluid and electrolytes

A

fluid volume deficit

19
Q

meds that decrease thirst sensation

A

benzos and SSRIs

20
Q

fluid volume deficit s/s

A
  • hypotension
  • tachy
  • orthostatic hypotension
  • decreased urine output
  • flat neck veins
  • weak pulse
21
Q

dehydration lab tests

A
↑ serum osmolarity
↑ creatinine
↑ BUN
↑ urine specific gravity
↑ electrolytes (because more concentration)
22
Q

What causes a reduced colloid oncotic pressure

A

Reduced levels of albumin

23
Q

What does protein do for fluid balance

A

Keeps fluid in the intravascular space

24
Q

What happens to the fluid when there is a reduced colloid oncotic space?

A

Third spacing (edema)

25
Q

Causes of increased hydrostatic pressure

A

elevated BP, fluid overload, decreased cardiac output

26
Q

causes of decreased colloid oncotic pressure

A

malnutrition, liver failure, nephrosis

27
Q

causes of blockage or removal of lymph nodes

A

mastectomy, lymphoma

28
Q

causes of increased capillary permeability

A

allergies, septic shock [endotoxin], pulmonary edema

29
Q

How can someone have a fluid volume deficit if they have too much fluid somewhere?

A

fluid compartments need a certain amount of fluid to operate smoothly

30
Q

s/s of fluid volume excess

A

(can be caused by hypertonic solutions)

weight gain of more than 0.5 kg/day, hypertension, bounding pulse, jugular vein distention, dyspnea, crackles, orthopnea

31
Q

Fluid volume excess treatment - medication class

A

furosemide, spironolactone, bumetanide, hydrochlorothiazide

32
Q

functions of electrolytes **

A
  • maintaining balance of water in the body
  • balancing blood pH
  • moving nutrients into the cells
  • moving wastes out of the cells
  • maintaining proper function of the body’s muscles, heart, brain
33
Q

Potassium normal range

A

3.5-5 mEq/L

34
Q

sodium normal range

A

135-145 mEq/Le

35
Q

calcium normal range

A

Serum: 8.9-10.5 mg/dL
Ionized: 4.5-5.6 mg/dL

36
Q

magnesium normal range

A
  1. 8-2.3 mg/dL

1. 3-2.1 mEq/L

37
Q

hypokalemia s/s

A

cardiac arrhythmias, constipation, fatigue

respiratory paralysis, paralytic ileus, tetany, hypotension, rhabdo, life threatening arrhythmias

38
Q

diuretics, metabolic alkalosis, chronic kidney disease, folic acid deficiency, gastrointestinal losses
can all cause…

A

hypokalemia

39
Q

How should you give potassium

A

ONLY given IV through a slowwwww infusion (burning feeling in vein)

40
Q

hypokalemia on diuretics: what change to make

A

switch to spironolactone

41
Q

acute renal failure, dehydration, diabetes, burns, acidosis, blood transfusion
are all causes of…

A

hyperkalemia

42
Q

s/s of hyperkalemia

A
  • nausea, vomiting, muscle aches, weakness, dysrhythmias,

- paralysis, heart failure, death

43
Q

Severe vomiting/diarrhea, drinking excess water, excess alcohol intake, thiazide diuretics, liver/heart disease
are all causes of…

A

hyponatremia

44
Q

when are hypertonic IV fluids used for hyponatremia

A

cerebral edema

45
Q

t/f: it’s important to improve sodium levels rapidly to avoid permanent damage

A

false: shift slowly to avoid rapid changes in neurological cells

46
Q

dehydration (incl from mild/moderate vomiting) and consumption of high sodium items can cause

A

hypernatremia

47
Q

What can cause cerebral edema with treatment of hypernatremia

A

if sodium is lowered too quickly

48
Q

inadequate vitamin D, decreased estrogen production, hypoparathyroidism, renal disease, low albumin levels, stimulant laxatives, chronic steroid use, proton pump inhibitors
can all cause…

A

hypocalcemia

49
Q

Positive Chvostek and Trousseau signs indicate

A

hypocalcemia

50
Q

s/s of hypocalcemia

A

chest pain, dysrhythmias, renal calculi, numbness and tingling, muscle cramping, confusion, osteopenia, dental problems

51
Q

is ionized or serum calcium more accurate

A

ionized (but serum is faster)

52
Q

cancer, hyperarathyroidism, vitamin D toxicity, TUMS can all cause…

A

hypercalcemia

53
Q

s/s of hypercalcemia

A
  • constipation, abd pain, nausea, vomiting
  • confusion, coma, death
  • renal failure, arrhythmias
54
Q

Crohn’s or celiac, diarrhea, pancreatitis, t2dm, hypokalemia/hypocalcemia, decreased intake, increased renal excretion can all cause…

A

hypomagnesemia

55
Q

hypomagnesemia s/s

A
  • Decreased appetite, fatigue, nausea, weakness

- Muscle cramps, numbness and tingling, seizures, tetany, and personality changes

56
Q

treatment for hypomagnesemia

A
  • oral or IV magnesium
  • treat hypokalemia and hypocalcemia first
  • educate clients on foods high in magnesium
57
Q

kidney disease, acidosis, hypothyroidism, trauma, medications that increase dwell time of food in the intestines, laxatives or antacids that contain magnesium all cause…

A

hypermagnesemia

58
Q

s/s of hypermagnesemia

A
  • dizziness, nausea, weakness, confusion
  • blurred vision, headache, bladder paralysis, bradycardia, reduced respiratory rate, loss of deep tendon reflexes, death
59
Q

hypermagnesemia treatment

A
  • calcium to help with heart problems
  • intravenous saline with diuretics
  • dialysis in severe cases
60
Q

sources of potassium

A

fruits, vegetables, orange juice, tomato juice

61
Q

sources of calcium

A

dairy, dark green vegetables, sardines, salmon, oysters, tofu

62
Q

sources of magnesium

A

nuts, egg yolk, milk, whole grain cereals, bananas, citrus fruit, dark green vegetables, legumes, seafood, chocolate

63
Q

sources of phosphorus

A

dairy products, meats, fish, bran and wheat cereals, nuts

64
Q

The nurse is caring for a client that has a Potassium level of 3.0 mEq/L. Which medication would the nurse expect to administer?

A

Potassium chloride (normal range: 3.5-5 mEq/L)

65
Q

The nurse is caring for a client with edema. Which lab value would the nurse prioritize on the lab results in relation to edema?

A

albumin

66
Q

The nurse is preparing to administer 0.45% sodium chloride to a client. Which description best matches what will happen to fluid with administration of 0.45% sodium chloride?

A

fluid will move from the intravascular space to the interstitial space